• Medicaid Data Strategy

    Guidehouse (Atlanta, GA)
    **Job Family** **:** Strategy & Transformation Consulting **Travel Required** **:** Up to 50% **Clearance Required** **:** None **What You Will Do** **:** We are ... of national healthcare reform and its impact on state Medicaid , public health or state and local health and...based on risk, coverage, and readiness. + Contribute to data conversion and migration assessments, including evaluation of mapping,… more
    Guidehouse (09/27/25)
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  • MITA ( Medicaid IT Architecture)…

    Public Consulting Group (FL)
    …program needs that enhance the lives of their user base. Services: + Strategy , Architecture, Planning, and Procurement + Business Enablement + Business Solutions + ... client and project. * Support the client and stakeholders in the planning and strategy discussions on the best approach for addressing risks and issues as they… more
    Public Consulting Group (08/08/25)
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  • Growth Strategy Consultant

    Humana (Columbia, SC)
    …to put those customers at the center of everything it does. The Growth Strategy Consultant (Distribution) provides data -based strategic direction to identify ... planning support for the Enterprise Growth vertical. The Long-term Growth Strategy Consultant 's work involves moderately complex assignments performed with… more
    Humana (10/02/25)
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  • CenterWell Strategy & Operations Senior…

    Humana (Frankfort, KY)
    …part of our caring community and help us put health first** The CenterWell Strategy Senior Consultant provides data -based strategic direction to support ... moderate to substantial where the analysis of situations or data requires an in-depth evaluation of variable factors. As...an in-depth evaluation of variable factors. As a CenterWell Strategy Senior Consultant , you will support the… more
    Humana (09/04/25)
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  • Director of Medicaid Reimbursement

    AdventHealth (Altamonte Springs, FL)
    Medicaid reimbursement process across the entire company focusing on supplemental Medicaid payments, provider taxes, Medicaid strategy development and ... implementation. Develops and implements company Medicaid strategy , both with leadership and key AdventHealth stakeholders, and...with multiple outside consultants and experts. Acts as a consultant to leaders ensuring the Medicaid rate… more
    AdventHealth (10/02/25)
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  • Strategy Consultant

    Health Care Service Corporation (Chicago, IL)
    …is responsible for supporting divisional short and long-term initiatives related to Medicaid provider network strategy and leverage analytics to drive provider ... and strategic network initiatives from inception to completion. This position will analyze Medicaid network data using internal and external sources to support… more
    Health Care Service Corporation (10/02/25)
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  • Care Consultant Sr

    Elevance Health (Seattle, WA)
    Provider Success Consultant Sr. (Value-Based) **Hybrid 1:** This role requires associates to be in-office **1 - 2** days per week, fostering collaboration and ... unless an accommodation is granted as required by law._ The **Care Consultant Sr.** (Provider Success) is responsible for the provider performance of value-based… more
    Elevance Health (10/04/25)
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  • OCM Consultant

    Public Consulting Group (Frankfort, KY)
    …program needs that enhance the lives of their user base. Services: + Strategy , Architecture, Planning, and Procurement + Business Enablement + Business Solutions + ... Project Assurance An OCM consultant will provide expert support and guidance to clients...methodology and change management tools to advise client on strategy to support adoption of changes for projects *… more
    Public Consulting Group (10/04/25)
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  • Pharmacy Network Consultant Sr - Remote

    Prime Therapeutics (Atlanta, GA)
    …passion and drives every decision we make. **Job Posting Title** Pharmacy Network Consultant Sr - Remote **Job Description** The Pharmacy Network Consultant Sr ... + Perform network development, network analysis and management activities supporting strategy and network management priorities and projects + Ensure all contractual… more
    Prime Therapeutics (10/04/25)
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  • Value-Based Innovation Consultant

    Highmark Health (Pittsburgh, PA)
    …Provider Transformation leadership and key matrix partners to execute on the strategy design and development of value-based programs across all provider types and ... across areas,; consistently updating and infusing the Organization's reimbursement strategy with innovative approaches to achieve return on investment (ROI)… more
    Highmark Health (09/05/25)
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  • Financial Consultant

    Public Consulting Group (Providence, RI)
    …Consulting and Billing Services + Applied Technology + Outsourcing and Operations + Strategy + Project and Grants Management + Assessments and Feasibility Studies We ... a strong emphasis on financial consulting, including cost analysis, funding strategy development, and fiscal impact assessments. You will help clients optimize… more
    Public Consulting Group (09/13/25)
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  • Transformation Program Consultant

    Humana (Washington, DC)
    …for the company's future. Transformation is critical to our core strategy : delivering great healthcare to seniors, providing a differentiated healthcare experience, ... the complex and coordinated effort required to execute the enterprise strategy : accelerating our long-term vision by identifying opportunities, designing solutions,… more
    Humana (09/30/25)
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  • Solution Adoption Consultant

    Waystar (Atlanta, GA)
    …of efficient processes that define the statements of work and engagement strategy - with the goal of driving improved client satisfaction, realizing booked ... Client Executive team is uniquely positioned to capture and define Waystar's product adoption strategy for a client. **WHAT YOU'LL DO** + Partner with sales teams -… more
    Waystar (09/04/25)
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  • Director of Health Economics & Field Reimbursement…

    J&J Family of Companies (Santa Clara, CA)
    …**Insights & Analytics** + Analyze field feedback to drive continuous improvement in strategy , tools, and training. + Use denials data to drive regional ... clinical, and other key functions to ensure alignment on field reimbursement strategy and execution. ** Consultant & Project Management** + Manage multiple… more
    J&J Family of Companies (09/30/25)
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  • Head of Contracts & Pricing

    Takeda Pharmaceuticals (Boston, MA)
    …of the US Oncology BU's (US OBU's) commercial and government pricing strategy and commercial contracting management, oversee advanced market access analytics, and ... marketing, finance and legal) that is responsible forthe pricing and contracting strategy across all US oncology customersegments. As the leader of this team,… more
    Takeda Pharmaceuticals (07/12/25)
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  • Enterprise Architect

    Humana (Indianapolis, IN)
    …the organization's strategy and long-term goals. + Serve as a consultant to application teams, guiding them in creating enterprise-grade applications that adhere ... standard design patterns. + Collaboratively map business vision and strategy to value streams, business capabilities, and functions. +...to governance standards (eg data use, cybersecurity, observability, residency, etc.). + Conduct various… more
    Humana (10/03/25)
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  • Business Intelligence Developer IV, Epic…

    Sutter Health (Sacramento, CA)
    …for ambulatory regulatory programs required by the Centers for Medicare and Medicaid Services (CMS), including the Merit-based Incentive Payment System (MIPS) and ... Maintains a thorough understanding of the latest CMS regulatory rules and data reporting requirements, ensuring compliance with all updates and revisions. Transforms… more
    Sutter Health (09/25/25)
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  • Healthcare Administrative Project Manager, New…

    City of New York (New York, NY)
    …and align public and private resources to match talent to opportunity; disaggregate data to understand and adapt to the rapidly changing labor market; leverage ... that strengthen New York City's healthcare workforce through informed health-policy strategy and cross-sector collaboration. This role calls for a self-starter who… more
    City of New York (08/14/25)
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  • Associate Director, Access Marketing, Entyvio

    Takeda Pharmaceuticals (Lexington, MA)
    …develop communication strategies and marketing tactics across the access ecosystem. + ** Data -driven Strategy :** Ensure clear performance metrics are in place and ... pathways to therapy as prescribed. + **Market Analysis and Strategy Development:** Evaluate market access trends and brand performance...leverage data to assess and report the effectiveness of strategies… more
    Takeda Pharmaceuticals (07/25/25)
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  • Provider Contracting Specialist - (Remote)

    CareFirst (Baltimore, MD)
    …contract terms in accordance with regulatory requirements, analyzing financial data to evaluate implications across various business lines, while ensuring ... **ESSENTIAL FUNCTIONS:** **Contract Development and Negotiation** + Serves as a consultant and subject matter expert (SME) in contracting and reimbursement, offering… more
    CareFirst (09/18/25)
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